In addition to being nominated for this Scholarship students must also fill out an application. Application requirements are listed on the front of the application.

School/Agency:
Address:
City:
State:
Zip Code:
Name of Person Completing Form:
Position:
Phone:
Email:
Name of Student You are Nominating:
Student's Address:
City:
Zip Code:
Student's Phone:
Please tell us why you are nominating this student for the Green Mountain College Make A Difference Scholarship. Please write your response below. Feel free to e-mail us additional information at admiss@greenmtn.edu
Applications are due by January 1. Please return the nomination form to Green Mountain College, Office of Admissions, GMC Make A Difference Scholarship Committee, 1 College Circle, Poultney, VT 05764 (800) 776-6675 or fax to (802) 287-8099.


©Green Mountain College,
One Brennan Circle, Poultney, Vermont 05764-1199
800-776-6675 Fax: 802-287-8099
www.greenmtn.edu